You can have a missing tooth in your mouth for various reasons. The tooth loss can be due to an accident, loose teeth due to gum infection, crooked teeth or broken tooth because of decay. Whatever be the cause of tooth loss, a missing teeth in your mouth can affect your speech, looks, chewing efficiency and also the ability to keep a patent airway!!!! An average adult in the age group of 35 to 49 years can have upto 3-4 missing teeth. So replacing your missing tooth becomes important.
When there are so many reasons to consider replacement of you missing teeth, let’s have a look at the options available to us
1) Dental Implant
Dental implant is one of the best tooth replacement options available today. The implants are made of titanium and are designed to replace lost natural teeth. They are inserted into your jaw bone. These implants act as the root of your tooth and will heal in the bone by integrating themselves with your jaw bone. The implants are a great solution for single missing teeth, although multiple missing teeth can also be replaced.
Advantages
- Success rate of implants is a 95%
- They are durable and long lasting
- Minimal maintenance other than the regular oral hygiene care and regular dental check ups and cleanings
- Implants give a natural feel, are comfortable and are good with aesthetics
- Implants prevents post extraction bone loss
- Adjacent teeth do not have to be trimmed
- They are cost effective in the long run because they are long-lasting.
Disadvantages
- The treatment procedure is invasive. Your dentist adapt to a surgical procedure to insert the implant.
- The treatment takes a longer time and your dentist will schedule multiple appointments to complete the treatment.
- Implant is the most expensive tooth replacement option.
When to choose dental Implants
Implants are the best choice when you are a suitable candidate and you can afford the treatment. Implants, although may be expensive are cost effective in the long run as they don’t have to be replaced as often as the fixed bridges. Implants also serve to preserve the jaw bone and the health of your gums. Additionally, your dentist will not grind the adjacent natural teeth. Implants also give the feel of natural teeth and no-one can say the difference between an implant and a natural tooth.
2) All-on-Four or All -on-Six Implant supported Denture
This method of placing either six or four implants in your mouth supports a full mouth denture. The “Overdenture” will clip into the fitting surface of the denture with the help of special attachments.
Advantages
- Helps make your denture strong and stable.
- Lesser mouth coverage than a full denture and hence makes you enjoy more variety of foods.
- Less bulky and does not hinder with your taste sensation.
- Can be removed easily by you for cleaning.
Disadvantages
- Implant supported dentures are still removable. Hence some of you will find it cumbersome.
- You have to be careful while eating hard or chewy food as this may damage your denture.
- The spacial attachments on the under surface of the denture needs more care in cleaning and must be replaced often.
When to choose an implant supported over denture
This system provides a more stable removable denture. Your denture gives you the feel of a fixed denture. In this system, the implants are placed in the more stronger and thicker bone that are better support to the implants. Sometimes, it is possible for your dentist to give you the denture within a day or two of placing the implants.
3) Implant supported Fixed bridges
In this system a few implants can support a full mouth fixed bridge. This bridge can be glued onto the implant or screwed into place. The screw system can have its own advantages wherein the bridge can be easily removed for better cleaning by your dentist. The screw holes will be covered by a tooth coloured filling and is not visible to the others.
Advantages
- Provides very good aesthetics and appearance.
- Feels and looks natural.
- Any type of food can be eaten well.
- Daily maintenance is easy with brushing and flossing.
- Cost effective as compared to replacing every single tooth with implants.
- Lasts a long time before it needs replacement.
- Grinding of healthy teeth by your dentist is not required.
Disadvantages
- When your missing teeth are spread out in the mouth such a system is not convenient
- Relatively expensive when the full arch has to be replaced.
- This requires more and longer appointments as compared to tooth supported fixed dentures.
- Placing the implants requires surgical procedure.
When to choose an Implant Supported Fixed Denture
This system more expensive than the implant supported removable denture. But it is beat suited for those of you who want to enjoy the stability of fixed dentures. This system also provides restoration of the missing gum tissue. So the aesthetics and natural look is well achieved.
4) Tooth-supported Fixed Bridge
A tooth supported fixed Bridge is the most common fixed tooth replacement option. This is the case particularly in a single missing tooth situation. A typical tooth supported bridge has two or more crowns on the supporting teeth called the ‘abutment’ and connected by the missing tooth which is called the ‘Pontic’. This is cemented or glued to th supporting teeth by your dentist. Various materials like metal, metal with ceramic or only ceramic is used to prepare the bridge.
Advantages
- The tooth bridged feel and function like natural teeth.
- It takes lesser number of appointments to complete the treatment.
- Daily maintenance is easy with only brushing and flossing.
- It is cost effective as compared to the implant supported replacements.
- The bridge is less risky than an implant wherein a failed bridge can be replaced by a new one.
- Treatment is non surgical painless and quick.
Disadvantages
- It is more expensive than the removable denture.
- The adjacent supporting teeth called the ‘abutment’ has to be trimmed. This may sometimes lead to tooth senstitvity later.
- The trimmed teeth are also prone to decay and infection especially if the oral hygiene is not maintained.
- The area under the Pontic has to be cleaned well. This can be a area of food trapment and lead to foul smell and even bone loss due to infection.
- The bridge is not as long lasting as the implant.
When to choose a tooth supported Bridge
Since everyone is not a good candidate for a surgical procedure, the fixed bridge can be a quick fix option. In people with compromised immunity the failure of implants is higher. Hence the fixed bridge serves well. The treatment can be completed in two appointments within a weeks time.
5) Removable Partial Denture
A removable partial denture is made to replace one or more missing teeth in your mouth. The missing teeth need not be one beside the other. The denture is generally made of acrylic supported with a metal framework. The denture base can be made with a more flexible material also in some cases.
Advantages
- Much cheaper than the fixed bridges and implants
- Very effective in replacing missing teeth restoring speech and aesthetics.
- Additional teeth can be added at times to the existing framework.
- Procedure is non invasive and quick.
Disadvantages
- The denture can be uncomfortable and unstable.
- May not give a very aesthetic look
- Initial speech problems can occur and you may need time to get your speech right.
- Need to be replaced frequently.
- The denture framework can be fragile and easily breakable.
- Every day removing from the mouth and cleaning is required to keep the denture clean.
- If you are not careful, the dentures can be lost.
When to choose a removable partial denture
This system is good choice when you need a quick, less expensive teeth set. It is the best choice when you have multiple mobile teeth that may need removal at a later date.
6) Removable Complete Denture
These are the complete dentures that you would have seen your grandparents were. The removable complete denture rests on your jaw bone. It has a pink coloured acrylic base simulating the colour of your gums and the teeth arranged on this plate.
Advantages
- These dentures can improve the aesthetics or appearance to a great extent and in turn boost your self confidence.
- The plates of these dentures support the surrounding muscles, lips and cheek creating a more youthful appearance.
- The dentures help in restoring good speech
- Eating efficiency is improved
- The dentures are affordable and quick to make
- They look close to natural teeth an duh size shape and colour can be adjusted to individual requirements
- The denture base can be relined and adjusted to the changing jawbone.
Disadvantages
- The dentures can become ill fitting in short time as the jaw bone changes shape
- The denture base may not be very stable especially the lower denture because of the tongue movement.
- Certain foods that are very hard or sticky cannot be eaten
- The denture can cause some bone resorption an making the denture loose fitting
- Since the plates are large an cover a substantial area of the mouth, taste sensation can be altered.
- The hard denture base can rub against the soft tissues of the gum and case sore spots.
- The denture can cause clicking sounds while talking and can be embracing in social interactions.
When to choose a removable complete denture
Anyone who cannot undergo a surgical procedure due to medical conditions or anyone who cannot afford implant supported dentures.
7) Resin Bonded Bridge or Maryland bridge
This a type of bridge that is used to replace the front teeth only. The Maryland bridge or the Rochette bridge is fragile and cannot withstand heavy chewing forces created by the back teeth. The bridge has wings made of metal that rests on the abutment with the Pontic attached to the wings.
The Rochette bridge has holes in the wings to improve the stability. This type of a denture has more stability than a removable denture but is not as strong as fixed bridge.
Advantages
- Cheaper than the fixed bridge.
- Since it is used for the front teeth, this restores you look sand aesthetics well.
- Provides good lip support.
- Prevents drifting of adjacent teeth.
Disadvantages
- Lacks strength and hence is used only for the front teeth
- You cannot bite on hard food with these dentures.
- Its not a long term option because its fragile.
When to choose a resin bonded bridge
When you are looking for a cost effective short term solution for your missing front teeth, the Rochette bridge is a good option. This can be used as a temporary reaction for an underlying implant.
8) Flipper or Temporary partial denture
This is a denture used to restore on for more missing teeth for a short period of time. The flipper is used only until that time a permanent replacement an be fitted.
Advantages
- These are inexpensive
- Can be used as ’Immediate Dentures”. The dentures can be fabricated before tooth removal and can be fitted immediately after extraction especially for the front teeth.
- Fabrication is very quick
- It is light in weight and comfortable.
Disadvantage
- It is not strong or stable
- It is fragile and is broken easily
- Can become bulky an uncomfortable to wear.
When to choose a Flipper
This is temporary denture that is used when you are waiting for a the implant to be restored or till such time you can decide on a more long lasting option.
